불현성 갑상선기능저하증 환자의 우울에 대한 체계적 문헌고찰및 메타분석
Depression in Patients withSubclinical Hypothyroidism: A Systematic Review and Meta-Analysis
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연구배경: 불현성 갑상선기능저하증의 증상으로는 우울증, 기억력 감소, 심근수축력 장애, 지질대사 장애, 동맥경화증 등이 알려져 있다. 그러나 불현성 갑상선기능저하증과 우울의 관계에 있어서는 일관된 결과가 제시되지 않고있다. 이에 본 연구에서는 불현성 갑상선기능저하증과 우울의 관련성에 대한 체계적 문헌고찰과 메타분석을 통해과학적 근거를 제시하는 것이다. 방법: 본 연구는 불현성 갑상선기능저하증 대상자의 우울에 대한 메타분석연구이다. 문헌검색을 위해서는 PubMed, EBSCO, ScienceDirect, 한국교육학술정보원(RISS)의 검색엔진을 이용하였고, 검색대상 연구는 1990년대 이후 발표된연구논문이었다. 문헌검색 결과 총 147개의 문헌이 검색되었으며, 최종적으로 분석에 포함된 연구는 10편이었다. 효과 크기의 통계적 분석은 Comprehensive Meta- Analysis software version 2.2.064를 이용하였다. 결과: 전체 10편의 연구 중 불현성 갑상선기능저하증과우울의 관련성이 있다고 보고한 연구가 5편이었으며, 이연구 중 여성을 대상으로 한 연구가 2편, 노인을 대상으로한 연구가 2편이었다. 불현성 갑상선기능저하증 환자의 우울의 효과 크기를 분석한 결과 효과 크기가 3.46 (95% CI 0.20-0.74, P=0.001)으로 불현성 갑상선기능저하증은 우울과 유의한 관계가 있는 것으로 나타났다. 결론: 본 연구는 불현성 갑상선기능저하증과 우울과의관련성에 대해 서로 상반된 연구 결과들이 보고되고 있는현 상황에서, 불현성 갑상선기능저하증과 우울의 관련성에대한 체계적인 근거를 제시하였다는 것에 의의가 있다. 또한 연구 결과는 불현성 갑상선기능저하증 환자의 정규적인우울 선별검사의 필요성을 제시하고 있으며, 특히 불현성갑상선기능저하증이 있는 노인과 여성이 우울 증상관리의주요 대상이 될 수 있을 것이다.
Abstract
Background: Symptoms of subclinical hypothyroidism include depression, memory loss, myocardial contractility disorder, lipid metabolic disorder, and atherosclerosis. However, the relationship between subclinical hypothyroidism and depression has not been consistent. Therefore, the purpose of this study was to provide the scientific evidence for the relationship between subclinical hypothyroidism and depression. Methods: This study was a meta-analysis of depression in subjects with subclinical hypothyroidism. The search engine of PubMed, EBSCO, ScienceDirect, and RISS was used to search the studies published since the 1990s. A total of 176 documents were retrieved from the literature search, and finally 10 studies were included in the analysis. Statistical analysis of effect sizes was performed using Comprehensive Meta-Analysis software version 2.2.064. Results: Of the 10 studies, five studies reported that depression was associated with subclinical hypothyroidism. Two of these studies were on women and two were on the elderly. The effect size of depression in patients with subclinical hypothyroidism was 3.46 (95% confidence interval 0.20-0.74, P=0.001), and the subclinical hypothyroidism was significantly associated with depression. Conclusions:This study showed that subclinical hypothyroidism is associated with depression. The results also suggest the need for regular screening of depressive symptoms of patients with subclinical hypothyroidism. Especially, elderly and women with subclinical hypothyroidism may be the main targets of depressive symptom
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